Aetna misled public about reasons for quitting Obamacare

[RiversideHusker]

... Aetna's decision to pull out of the exchange business in Florida was "so far outside of normal business practice" that it perplexed the company's top executive in Florida, who was not in the decision loop.

"I just can't make sense out of the Florida dec[ision]," the executive, Christopher Ciano, wrote to Jonathan Mayhew, the head of Aetna's national exchange business. "Based on the latest run rate data . . . we are making money from the on-exchange business. Was Florida's performance ever debated?" Mayhew told him to discuss the matter by phone, not email, "to avoid leaving a paper trail," Bates found.

From http://www.latimes.com/business/hiltzik/la-fi-hiltzik-aetna-obamacare-20170123-story.html

[blizz01]

Hmm - what about UnitedHealthGroup?

[vicupstate]

This should be a business and PR nightmare for them, but it will be forgotten soon. Inauguration numbers will get much more attention.   

[BridgeTroll]

This should be a business and PR nightmare for them, but it will be forgotten soon. Inauguration numbers will get much more attention.   

Inauguration numbers, vote numbers, march numbers...

[mbwright]

We are all losing with the current healthcare situation.  COST, which was never discussed as part of ACA, or Medicare D for that matter, has been the biggest issue.  If you can't afford to use your insurance, what good is it?  High annual deductibles are outrageous. If you can't afford medication, what good is it?  I have seen absolutely nothing that is addressing the rampant increase in the cost of services and drugs, aside from insulin, Hep C and a few other drugs that got some coverage about  700% increases in price. 

[Todd_Parker]

We are all losing with the current healthcare situation.  COST, which was never discussed as part of ACA, or Medicare D for that matter, has been the biggest issue.  If you can't afford to use your insurance, what good is it?  High annual deductibles are outrageous. If you can't afford medication, what good is it?  I have seen absolutely nothing that is addressing the rampant increase in the cost of services and drugs, aside from insulin, Hep C and a few other drugs that got some coverage about  700% increases in price.

To be fair, there are usually good justifications for those massive increases in prices:

http://www.vanityfair.com/news/2015/12/martin-shkreli-wu-tang-album

[Gunnar]

We are all losing with the current healthcare situation.  COST, which was never discussed as part of ACA, or Medicare D for that matter, has been the biggest issue.  If you can't afford to use your insurance, what good is it?  High annual deductibles are outrageous. If you can't afford medication, what good is it?  I have seen absolutely nothing that is addressing the rampant increase in the cost of services and drugs, aside from insulin, Hep C and a few other drugs that got some coverage about  700% increases in price.

To be fair, there are usually good justifications for those massive increases in prices:

http://www.vanityfair.com/news/2015/12/martin-shkreli-wu-tang-album

Absolutely, and it's unbelievable that people are complaining about petty things like higher drug prices when there are much more fundamental things at stake. Just imagine the album had gotten into Quentin Tarantino's hands? Or even worse - I still shudder at the thought - into the hands of fans. I think the goal was to save people from wasting their money on the Kickstarter campaign, so this was an altruistic gesture, really. 

[MusicMan]

I'm having trouble wrapping my head around (1) we are supposedly the wealthiest country in the world and (2) we can't seem to afford anything.....................

[mbwright]

I do agree that ACA has helped millions get insurance they otherwise did not have access to.  I am not denying that.  It is just that cost for healthcare in general has increased significantly faster than inflation and general income.  I guess for the 1% it does not really matter, but for most is does. 

[Non-RedNeck Westsider]

I've been against the ACA from the outset because it was a compromised, half-assed solution.  The government is requiring people to use a service that is provided by a for-profit industry.  My view of that means that the government is guaranteeing profits.   In an altruistic world, that may be fine, the providers would welcome new startups and share the costs and across the board (which would lessen) with their competition knowing that they would all be in the black (but not as much as they could be) at years end because the government said so. 

Capitalism doesn't work that way.  It's not about splitting the pie.  It's about taking the whole pie, the recipe for the pie, and controlling every resource required to make said pie.  Selling it back and making profits at every juncture.

This was never going to work as is.

For the record, I have an exemption as a sole proprietor.  My kids are covered under a corporate plan through their mom.  And I honestly can't tell you the last time I've had to see a doctor {knocks on wood}, so a semi-healthy lifestyle plays a big part in my decisions and views.

[Gunnar]

I'm having trouble wrapping my head around (1) we are supposedly the wealthiest country in the world and (2) we can't seem to afford anything.....................

It depends on who "we" is.

Another thing is the imho obscene profits. I am all for companies making healthy profits, and personally I do not care if companies who make non-essential goods (e.g. Apple) make obscene profits. If people are willing to pay the asking price, fine for them.

What irks me is that insane profits mean that the markets are not working properly and if they are at least partially based on a successful tax avoidance strategy it means they are based on ... let's say "withholding" funds from the public.

[Tacachale]

It isn't the profits that are the problem. In fact, that's a large part of what drives the industry to do as much research as they do - research that simply wouldn't be done if these companies weren't doing it. The real problem is the cost of healthcare in the U.S., which is higher than virtually any other country. The ACA didn't tackle that and it seems unlikely that any future plan will succeed without it.

[Non-RedNeck Westsider]

It isn't the profits that are the problem. In fact, that's a large part of what drives the industry to do as much research as they do - research that simply wouldn't be done if these companies weren't doing it. The real problem is the cost of healthcare in the U.S., which is higher than virtually any other country. The ACA didn't tackle that and it seems unlikely that any future plan will succeed without it.

Cost and profits kind of go hand in hand. 

{Extremely simplified explanation below}

From the doctors to the pharmaceutical companies to the insurance providers....   

IMO, this plan never had a chance without a complete overhaul of everything relating to sickness.   They would have to regulate the profits out of something to make it work.  Think of a Venn Diagram.  Three bubbles of a.) overly regulated Medical Staff / Facilities, b.) overly regulated Pharma and c.) Overly regulated Insurance providers.  Combine the three with Single-Payer system being in the middle.

And by overly-regulated, I'm trying to infer limited profits to manage costs.

The next step is to proved competent people wanting to go into a profession that limits their earning potential.  Which would lead to free/low cost medical schools.  Or riskier pharma getting through, or defaulting insurance companies...

Here's a plan - if the government is going to 'mandate' insurance, why not 'mandate' healthier living, too?  Too much infringement?

[Gunnar]

It isn't the profits that are the problem. In fact, that's a large part of what drives the industry to do as much research as they do - research that simply wouldn't be done if these companies weren't doing it. The real problem is the cost of healthcare in the U.S., which is higher than virtually any other country. The ACA didn't tackle that and it seems unlikely that any future plan will succeed without it.

If it's so expensive, where is the money going ? I understand that advances in medicine have also resulted in more expensive equipment, treatment and testing but is the increased cost only due to this ?

[Gunnar]

It isn't the profits that are the problem. In fact, that's a large part of what drives the industry to do as much research as they do - research that simply wouldn't be done if these companies weren't doing it. The real problem is the cost of healthcare in the U.S., which is higher than virtually any other country. The ACA didn't tackle that and it seems unlikely that any future plan will succeed without it.

Cost and profits kind of go hand in hand. 

{Extremely simplified explanation below}

From the doctors to the pharmaceutical companies to the insurance providers....   

IMO, this plan never had a chance without a complete overhaul of everything relating to sickness.   They would have to regulate the profits out of something to make it work.  Think of a Venn Diagram.  Three bubbles of a.) overly regulated Medical Staff / Facilities, b.) overly regulated Pharma and c.) Overly regulated Insurance providers.  Combine the three with Single-Payer system being in the middle.

And by overly-regulated, I'm trying to infer limited profits to manage costs.

The next step is to proved competent people wanting to go into a profession that limits their earning potential.  Which would lead to free/low cost medical schools.  Or riskier pharma getting through, or defaulting insurance companies...

Here's a plan - if the government is going to 'mandate' insurance, why not 'mandate' healthier living, too?  Too much infringement?

It's not only about healthy living (that certainly helps) but also about prevention, i.e. free check-ups, vaccinations, preventive care that has to start early on. This may help prevent more expensive diseases / damage in the future.